An optimization approach to panel size management

Abstract

We consider the panel size management problem that aims to balance workloads among providers within a health care system, where the ratio of a primary care provider’s load to their own daily full capacity is used as a measure for overload or underload. While transferring patients from their existing providers to others is the means to achieve workload balance, several practical restrictions prohibit transfer if patients have multiple chronic conditions or should there be other reasons to discourage assignment changes. We also consider patients requests for specific characteristics of providers (e.g., same gender, same geographic location). In case the current system is greatly stressed even with patient panel reassignment, we allow for hiring new providers strategically at appropriate practice groups so that load balancing is achieved for the system (with new hires) and the utilization of no provider, existing or newly hired, exceeds a threshold value. Data analysis on provider panels from a Louisville regional health care system is performed and is used in developing an integer linear program model for the problem. Three case studies based on the data for the regional health care system show that the proposed model is effective in achieving load balancing and preventing physician burnout.